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PubMed2005

More than 56,000 children with disabilities in Tennessee.

Since 1990, Tennessee has been ranked among the states with a series of health and social difficulties. In addition, there are more than 56,000 children with disabilities in the state. In an effort to personalize these findings, the numbers of children with disabilities are presented by city, metropolitan area, county, and congressional districts. There are numerous difficulties associated with the delivery of dental care to these children with special needs. If all dentists were willing to help, however, each practitioner would need to care for twenty of these youngsters.

Adolescent↗

PubMedDate not supplied

Residual developmental disabilities in children with transient hypertonicity in infancy.

Developmental disabilities occurred in children who manifested transient neurologic abnormalities in early infancy. In an attempt to identify associated problems at an earlier age, the neuromotor and developmental progress of 33 children who had transient hypertonicity during early infancy was analyzed. At 2-3 years of age, various developmental abnormalities were identified in more than two-thirds of these children. Delays in speech and language development and also in fine motor/adaptive and behavioral difficulties were most frequently present. Over time, these problems persisted and other disorders also became apparent. At 5 years of age or older, learning disabilities were frequent and associated with language and perceptual problems. None of the patients had epilepsy; mental retardation was present in only 2 children. Our study demonstrates that children with transient hypertonicity in early infancy are at risk for various developmental problems which can be identified as early as 2 years of age. It also indicates that although their severity lessens over time, these developmental abnormalities tend to persist.

Adolescent↗

PubMed1996

Toward a new psychometric definition of social disability in children with attention-deficit hyperactivity disorder.

OBJECTIVE: To investigate a new mechanism for identifying social disability in children with attention-deficit hyperactivity disorder (ADHD), employing psychometric methodology used in defining learning disabilities. METHOD: Two groups of index children were examined: 140 children with ADHD (referred from both psychiatric and pediatric sources) and 120 non-ADHD comparison children. Subjects were defined as socially disabled if they had a value greater than 1.65 on a standardized discrepancy score between observed and expected scores on a measure of social functioning (with expected scores derived as a function of the child's estimated Full Scale IQ). Children identified as socially disabled were compared with non-socially disabled probands on psychopathology, familiality, cognitive functioning, school history, and treatment history. RESULTS: Using this psychometric approach, 22% of the ADHD probands qualified as socially disabled, whereas none of the comparison probands qualified (p < or = .001). Socially disabled ADHD probands were significantly more impaired than were non-socially disabled ADHD probands in global and specific measures of social functioning and patterns of psychiatric comorbidity. CONCLUSIONS: The psychometrically defined construct of social disability may identify children with ADHD who are at very high risk for severe social dysfunction and whose course and prognosis may vary from those of other children with ADHD. This subgroup of children with ADHD may be at heightened risk for poor outcome, and their identification may facilitate the development of clinical interventions aimed at ameliorating their specific difficulties.

Adolescent↗

PubMed2000

A therapy-relevant casemix classification system for school-age children with disabilities.

OBJECTIVE: To develop a clinically meaningful classification system of resource-homogeneous groups to describe therapy resource use for school-age children with disabilities. DESIGN: Work-time allocation survey of therapy services (physical therapists, occupational therapists, and speech pathologists). SETTING: Three main disability agencies in Western Australia. CLIENTS: All children of two agencies, a random sample of children of the third. A total of 644 clients and their services were studied. MAIN OUTCOME MEASUREMENT: Minutes of therapy service time expected over a 10-week school term. RESULTS: Forty-six percent of the variance in a measure of time spent with clients can be explained using a classification system of nine groups, based on splitting a mobility measure (4 major groups), then the nature of primary disorder (2 subgroups), independence in self care (3 subgroups), and expressive communication (3 subgroups). CONCLUSION: This study defines a preliminary classification system for the distribution of therapy resources to school-age children with disabilities. This model has the potential to be used to purchase services on a fairer basis than traditional, historical funding methods have allowed.

Child↗

PubMed2003

Do the reading disabilities of children with cleft fit into current models of developmental dyslexia?

OBJECTIVE: The purpose of this study was to determine whether the reading problems of children with cleft fit models of developmental dyslexia. DESIGN: The study compared children with nonsyndromic cleft lip and palate who had reading disability (n = 46) with those who did not have reading disability (n = 46). The children were matched for age, sex, and grade. The two groups were compared (t tests) on measures of verbal expression, phonemic awareness, and rapid naming. Also, regression analyses compared the relative relationships of these variables to reading disability. PARTICIPANTS: Children were selected from 154 patients originally screened. RESULTS: Children with reading disability scored significantly lower on rapid naming and verbal expression, with no differences found on phonemic awareness. Rapid naming was shown to have the most significant association with reading disability. CONCLUSION: Children with nonsyndromic cleft lip and palate show symptoms similar to a naming-memory deficit model of developmental dyslexia. Reading treatment should avoid sight word approaches and focus on oral phonics treatment.

Anomia↗

PubMedDate not supplied

Alpha hemispheric asymmetry in children with learning disabilities and normally achieving children during story comprehension and rehearsal prior to narrative production.

Twelve children with learning disabilities attending a remedial summer clinic were compared with 12 normally achieving controls balanced for age, sex, and handedness on alpha amplitude and production of narratives. Specifically, all subjects participated in three conditions. Condition 1 was a vigilance condition, Condition 2 involved listening to a story without an ending that had to be retold, and Condition 3 was an opportunity to rehearse the story mentally and construct an appropriate ending. Alpha amplitudes were monitored during the three conditions to determine any hemispheric asymmetry or differences between groups or conditions in alpha production. The subjects' narrative productions of retelling the story with a novel ending were also analyzed using a cohesion analysis procedure. The results showed no significant differences between the groups in alpha amplitude, but there was a significant task effect with the vigilance condition, story comprehension, and rehearsal showing decreasing alpha amplitudes in both groups of subjects. Analysis of the narratives showed the group with learning disabilities to produce significantly shorter and less cohesive stories. Results are discussed in relation to other studies of hemispheric processing differences in populations with learning disabilities.

Alpha Rhythm↗

PubMedDate not supplied

Experiences with a support group for grandparents of children with disabilities.

A support group for grandparents of children with severe disabilities was developed to meet grandparents' needs and to maximize their ability to serve as resources for the parents. Discussion themes provide insights into their experiences. Issues not previously discussed in the grandparenting literature are disclosed.

Child↗

PubMed2003

Informing parents of visually impaired children: who should do it and when?

BACKGROUND: Parents of sick or disabled children are likely to be more stressed than parents of non-disabled children and may benefit from being given information about their child's condition and its implications, but the stage at which parents should receive such information and who should provide it has not been fully investigated. The impact of written information on stress levels of parents of visually impaired children, seen in the ophthalmology clinic of a children's hospital, was explored in this study and the question of who parents thought should provide information, and at what stage, was also investigated. METHODS: A longitudinal, experimental intervention study was conducted to compare the effect on perceived stress levels of providing information about the implications of visual impairment to parents. Effects were compared according to the child's age and explored in relation to baseline stress levels. The study included a frequency analysis about parents' knowledge of visual impairment and how it relates to education, and their response to being given written information. RESULTS: The results did not show an effect on levels of parental stress but did find that parents of school age children were more stressed than those of preschool age. Over 80% of participants considered that information was given too late and suggested it should be given soon after diagnosis. Of the controls, 32.6% thought the general practitioner should provide information on education although participants were more likely to expect the hospital to provide it. CONCLUSIONS: The majority of parents would prefer to receive information soon after diagnosis of their child's visual impairment. Most parents do not know who to approach for information on education. Giving them access to patient liaison teams who could advise about the repercussions of visual impairment in children would be beneficial.

Case-Control Studies↗

PubMed1998

Physical activity play in children with disabilities: a neglected opportunity for research?

Studies of the development of children with disorders of motor function afford opportunities, as yet unexploited, to understand the importance of motor function to overall child development. Pellegrini and Smith's review provides a challenge to developmentalists from many disciplines to use this natural model of developmental variation to move the field forward.

Adolescent↗

PubMed2005

The accessibility of general NHS services for children with disabilities.

Through conversations with members of a parent-run support organization, mixed concerns were identified about the accessibility of general National Health Service (NHS) services for children with disabilities. A questionnaire, aimed at uncovering the main issues related to general health services for children with disabilities was designed with representatives from the parent-run support organization. The questionnaire was administered as part of a semi-structured interview with 25 parents of children with disabilities (mainly learning disabilities). Eight themes were reported 'preparation', 'flexibility', 'parking', 'physical space', 'waiting areas and consultation rooms', 'health professionals' understanding and knowledge of disabilities, particularly around communication', 'on the wards' and 'overseeing care'. Themes are presented with parents' useful comments and suggestions. As the themes are wide ranging it is suggested that the research be repeated, focusing in on particular areas of general NHS services.

Adolescent↗

PubMed2006

The influence of the training and support programme on the self-efficacy and psychological well-being of parents of children with disabilities: a controlled trial.

The purpose of the study was to examine the effectiveness of an intervention for parents of children with disabilities in a controlled study focusing on parents' self-efficacy, psychological well-being and perceptions of change in children's sleeping, eating and mobility. The Training and Support Programme (TSP) was designed to equip parents with a simple massage skill that they could use with their children in the home environment. Parents were trained in massage by therapeutic massage therapists in 8-weekly sessions, each lasting 1h. The sample comprised 95 parents (49 in the Intervention Group, 46 in the Waiting-list Control Group) who attended the TSP with their children. Data were collected by self-administered questionnaires at baseline (before commencing the TSP), and at 8-week follow-up. The TSP demonstrated statistically significant positive effects on parents' anxious mood, self-efficacy for managing children's psychosocial well-being, self-efficacy in giving massage therapy, and perceptions of children's sleeping and eating. Relatively high levels of psychological distress were found among parents, particularly mothers. Overall, findings suggest that wider implementation of the Programme is warranted, and greater attention needs to paid to the psychological well-being of parents caring for children with disabilities.

Adaptation, Psychological↗

PubMed2003

"What do you mean 'what's wrong with her?'": stigma and the lives of families of children with disabilities.

This study extends the application of modified labeling theory to the experience of courtesy stigma in families of children with disabilities. The study utilizes a mixed methods approach that integrates quantitative analysis of survey data, qualitative analysis of interactive interviews and personal narrative. A survey of 81 mothers of children with disabilities in Florida, USA, is used to test hypotheses related to the impact of perceived stigma on emotional and social outcomes for mothers and children. The author's experience as the mother of a child with cerebral palsy and interactive interviews with seven other mothers with similar experiences are used to contextualize, humanize and help interpret the quantitative findings. Results indicate that controlling for the effects of salient maternal and child characteristics and the daily hassles of caring for a child with a disability (objective burden), maternal perceptions that individuals with disabilities are devalued and discriminated against (stigmatized) by others increases maternal distress (subjective burden). Findings also indicate that children of mothers who perceive high levels of stigma interact less frequently with age peers in the informal settings of homes and neighborhoods.

Attitude to Health↗

PubMed1995

Social insurance provisions for children with disabilities in selected industrialized countries.

In the United States, low-income families who have a child or children with a disability may be eligible for cash benefits payable under the Supplemental Security Income (SSI) program. In the last few years, the number of these children on the SSI rolls has increased dramatically due, in large part, to new standards developed in response to a 1990 Supreme Court decision and the subsequent retroactive activity as a result of that decision. The rise in the number of child beneficiaries has led to increased concerns as to whether cash benefits are the best way to help these children and their families deal with the additional needs and expenses caused by disabilities. This article begins with a summary of recent American developments regarding the childhood disability issue as background to an exploration of comparative practices. In light of the current interest in the United States concerning children with disabilities, it seems timely to explore the approaches used by other countries' social insurance programs. This study details the practices and provisions of 14 European countries and 4 other developed countries (Australia, Israel, Japan, and New Zealand). In addition to examining the variables involved in making cash benefits available and awarding them to families on behalf of disabled children, the article also provides information on in-kind benefits to which such families would be entitled and gives some insight as to the philosophy and policy goals of selected foreign programs.

Adolescent↗

PubMed1984

The Luria-Nebraska Neuropsychological Battery-Children's Revision: comparison of learning disabled and normal children matched on full scale IQ.

17 academically normal and 17 reading disabled children were matched on Full Scale IQ and compared on the Luria-Nebraska Neuropsychological Battery-Children's Revision. The academically normal group performed significantly better on the Expressive Language, Writing, Reading, and Rhythm subscales, which suggests that the Luria-Nebraska may be sensitive to deficits not reflected in Full Scale IQ. Results are consistent with previous research and support the validity of the Luria-Nebraska, although simplistic interpretation of the battery's subscales should be avoided.

Adolescent↗

PubMed2002

Perceived risk among parents concerning the travel situation for children with disabilities.

The aim of this study was to describe perceived risk among parents concerning the travel situation for children with disabilities, in addition to their self-reported knowledge of regulations and standards. The results from the present questionnaire study showed that entering and exiting the vehicles often required manual assistance and, thus, was perceived as risky, creating worry among parents. Parents were also worried about professional drivers' lack of knowledge about the child, incautious driving behaviour and lack of adequate safety measures. A poor postural sitting position was a problem in all vehicles. Half of the parents lacked knowledge about the regulations and standards for school transportation and Special Transport Systems. Lack of information seems to be one underlying reason for the parents' worries. Comprehensive information, focused on the special needs of children with disabilities in their transportation, would probably reduce the parents' worries significantly.

Adolescent↗

PubMed2002

Increasing touch between parents and children with disabilities: preliminary results from a new programme.

Initial findings are presented from a specially devised touch therapy programme for parents of children with disabilities. A total of 42 parent children have completed the programme. Therapists teach parents simple massage techniques during one-hour sessions held once a week for eight weeks. The children had a range of disabilities including cerebral palsy, asthma, sensory impairments and Down's syndrome. Parents reported improvements in children's muscle tone, joint mobility, sleep patterns, bowel movements and response to other forms of therapy, e.g. physiotherapy. Parents also reported that they themselves had benefited, e.g. by feeling "closer" to their child and less stressed.

Adolescent↗

PubMed1994

[A study on the causes of the physical and mental disabilities in children].

The causes and time of onset of physical and mental disabilities in children were investigated. Among 72 subjects, the causes of the disabilities were clearly verified in 43 cases, that is, 21 cases of hypoxic ischemic encephalopathy (29%), 12 cases of cerebral malformations (17%), 7 cases of other congenital malformations (10%), and 3 cases of intrauterine infections (4%). In 10 cases from the remaining 29 subjects, the disorders during perinatal period were strongly suggested from the findings of CT and MRI.

Brain↗

PubMed2004

Dilemmas in sharing care: maternal provision of professionally driven therapy for children with disabilities.

This paper explores some of the dilemmas that result when mothers and professionals collaborate in providing care to young children with disabilities within a US public program called Early Intervention. Successful collaboration between professionals and activist parents resulted in the program having a "family centered" approach, but the implementation of that approach is problematic. Professionals transmit therapeutic knowledge and skills to mothers of young children with special needs, urging them to perform therapeutic care work with their children. Through these efforts, professionals create a "therapeutic imperative" for mothers, expecting them to do therapeutic work that usually exceeds the amount of work that professionals do with their children. This paper explores the dilemmas mothers and professionals face when implementing family centered care and the ways in which mothers and professionals negotiate contested understandings of the optimal mixture of public (professional) and private (maternal) provision of therapeutic care to young children with disabilities.

Attitude of Health Personnel↗